Why Aren’t More Physicians and Patients Bringing Up the Topic of Weight?

Do you hesitate to talk to your doctor about your weight? Your doctor might be hesitating, too. We talk to an endocrinologist to find out the reasons why both sides are struggling to address this sensitive subject and what may be done to help.

“The survey shows a staggering 82 percent of adults are currently over their ideal weight. When it comes to shedding excess pounds, 4 out of 5 Americans say that hearing from a doctor that they need to lose weight would motivate them (83 percent). An even greater number (90 percent) say they would be influenced if a doctor told them that they have a serious health risk. Yet, only 1 in 5 Americans say they’ve actually asked their primary care doctor for weight loss help or advice (20 percent).”

According to those results, one would get the idea that many patients do not have a healthcare provider who is addressing a serious health issue. Perhaps doctors assume everyone is well aware of the risks of being overweight or obese? Or is the topic too touchy to go into? Do physicians not fully realize the extent of their influence?

A “Combination of Factors” Involved

This is due to a “combination of factors” says, Dr. Minisha Sood, MD, FACE, ECNU who practices in New York City’s Fifth Avenue Endocrinology.

Dr. Minisha Sood | Photo credit: endocrineonfifth.com

“Physicians are pressed for time in addition to there being a perception that patients don’t want to discuss the topic of weight.” She explains it’s a “delicate area” and that many doctors wait for the patient to initiate discussion on the subject. The survey results give the impression patients are waiting for their doctor to start the conversation.

Also, she notes that many physicians learn little about nutrition, obesity, and lifestyle counseling. Many physicians these days are now choosing to specialize in areas like obesity knowledge and treatment to better serve their patients.

Dr. Sood, an endocrinologist herself, is currently about to take her board exams in obesity knowledge–she has made herself educated on the topic for some time but wants to signal that she specializes in this area. This may help patients feel more comfortable bringing up their concerns about their weight.

Doctors Have a Responsibility to Bring it Up

The truth is that obesity is a serious condition and people generally hold the opinion of their physician in high regard. Perhaps, partially due to this some patients avoid coming in for a visit for fear that their provider will bring up the topic of their weight. It’s reasonable that some patients are not ready to discuss their weight at any given time.

Dr. Sood states that providers do have the responsibility to address the issue, however.

How can this be done in a way that works for both parties involved?

The topic can be brought up in “a nonjudgemental manner where the physician asks for permission to discuss the topic with the patient” suggests Dr. Sood. In fact, she does this with her patients. She offered the example of a middle-aged patient she had who was severely obese. He was not in her office for concerns about his weight, but she let him know that they needed to discuss his weight at some point in time because she understands the metabolic and health-related complications related to obesity. She respectfully asked him to let her know when he was ready to talk.

“Two weeks later he called to talk about it, I put him on some medication, and he lost 80 pounds,” shares Dr. Sood. “All I had to do was bring it up.”

“We physicians have to recognize the power we have,” she adds.

Tackling a range of barriers with increased physician training on lifestyle management, nutrition, and obesity as well as the media getting the word out, says Dr. Sood, should help drive more of these crucial conversations. She highly recommends providers broach the topic by asking the patient for permission to discuss before going any further and using nonjudgemental language. After all, obesity is considered a medical condition.

For those wanting to talk about their weight with their provider, it may help to know that they want to help you in this area but might be waiting for you to initiate the discussion. Hopefully, with time, more patients and providers will find a way to start the conversation as only then can solutions be discussed. As Dr. Sood says, the goal is to “open the doors” for communication.

Sysy Morales is a staff writer and editor at Diabetes Daily and has lived with type 1 diabetes for 24 years. She has led dozens of diabetes education and motivational programs across the country and is a graduate of The Institute for Integrative Nutrition. Sysy started blogging about diabetes at The Girls Guide to Diabetes after the birth of her twins to share how she maintained recommended A1C levels during that time. What she has learned about diabetes dramatically improved her life and she is now obsessed with sharing information that may help other people with diabetes thrive, too.